| NPI | 1740433440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 1372) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC LL1372) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2012-05-22 |